New technologies for use in medicine are changing how health care is being delivered, improving the patient experience, facilitating the convenience and ease of feedback between providers and patients, and allowing for low-cost interventions whereby large populations can be assessed and treated.
In particular, technology has made a big impact on the treatment of chronic illnesses, such as major depression, because technology offers self-management strategies and significantly improves adherence to medications with reminders and messages of support.1 Health technologies can help mitigate medication errors, help patients understand prescribing practices, and track the efficacy and acceptability of medications used to treat depression.1
But the real appeal of mobile health technology is how it relates to individualized patient care. There are different types of technology and digital interventions that are feasible to support the treatment of depressive disorders, meaning providers have options when determining which approaches to health technology are most effective and promote optimal engagement with end users.
Mobile Health Technology Platforms for Treating Depression
Smartphone Health Applications
Smartphone applications that offer health interventions are increasingly available and easy to use. Diverse in content and the conditions they approach, strategies adopted by health applications typically incorporate identified behavior change theories into the application design.2 When developed with the usability of the patient or end user in mind, these applications can facilitate successful health behavior changes.
Although smartphone applications are still a relatively new format for digital interventions, not all health applications are created equally, and approaches used to evaluate accuracy, usability, and efficacy of these apps are still being researched.2 For the treatment of depression, mobile applications are appealing but should ensure accuracy of the medical advice provided, usability of features, and responsiveness to different clinical scenarios.
Automated voice response systems are a commonly applied mobile health technology that can handle large volumes of calls. These systems are useful for symptom management, to measure symptom severity, and to deliver self-management strategies for several chronic conditions.1 Along with short message services, these systems have also been associated with improved patient adherence to medications because of electronic reminders and support.1
Use of barcode technology for managing prescription information can be valuable to mitigate medication errors, but their true benefit for the management of depressive disorder is to understand the providers’ prescribing practices and provide insight into the efficacy and acceptability of antidepressants.1
In-home monitoring technologies, which can be as simple as videoconferencing through an application that is compliant with the US Health Insurance Portability and Accountability Act, have a role in protecting patients’ autonomy by proactive monitoring and providing support that is more personal and adaptive to an individual’s needs.1 The ability to maintain autonomy may contribute to quality of life factors, especially in older patients or in patients with chronic disorders or who have physical limitations.
Social media provides a valuable platform for online healthcare communities where patients can share experiences and resources for managing symptoms. In the article titled “Maximizing New Technologies to Treat Depression,” Decker et al writes, “Debilitating symptoms, as well as declining social contacts, are frequently coupled with social isolation and depression in [adults]. Social media provides a platform … to receive emotional support instrumental for the maintenance of positive mental health.”1
Decker et al continues, “Depression remains a highly stigmatized condition that creates a barrier for people to openly discuss their mental health experiences. Online healthcare communities provide a safe place for people to share experiences and seek support from peers.”1
Social media can be used as a tool to match adults with depression to appropriate peer-support specialists, mental health professionals, coaches, or mentors.1 Similar to traditional face-to-face support groups, online communities using moderators can help identify topics related to depression and individual challenges of group members while offering support resources.
Anonymous Screening Tools
Digital screening tools, such as anonymous surveys, provide users a simple, nonthreatening platform that can increase their self-awareness about depression. Responding to results, these tools may direct users toward appropriate community resources or recommend they schedule a follow-up screening with their health care provider.1 Anonymous electronic tools are nonconfrontational and offer instant access, which is valuable for persons experiencing life-changing events or to assess changes in depressive symptoms.
Wearable technology is valuable for monitoring health trends and collecting important health data. In the treatment of depression, wearable devices record changes in data that trigger an indication of depression or changes in mental health. In response, these devices send a message of support or encourage the patient to make an appointment with a health care provider.1
Engagement Approaches to Improve Impact of Health Technology
Designing effective health technologies is a process as important as the impact they can make. Mobile applications, computerized therapy, and other digital tools rely on design to foster optimal engagement with end users. To do this, the most valuable process includes defining the preferences of different groups of end users, understanding their mental health needs, and appealing to their cultural and demographic characteristics.3
In study populations, preferences regarding the look and feel of a mobile health technology application were diverse and often noncompatible; this means offering a range of digital therapeutic approaches is a better way to engage a large treatment population on an individualized level.3 In fact, the appropriate content according to studies of mobile health technology to treat depression should focus on identity, mental well-being, and individual strengths.3
There are exciting opportunities in designing health technology that exploit contemporary formats and styles, like gamification or telepresence, but with any approach, the usability of mobile technology to treat depression depends on upholding a normalizing, nonthreatening tone.3
Implementation Strategies to Maximize Engagement and Impact
Engagement also requires strategic implementation processes, for example, promotional activities that pique users’ interest and create awareness of their digital health options. In treating depression, users (especially younger persons) often have patterns of help-seeking that include reporting about distress on social media or in online communities, but do not seek help directly from professionals or by accessing mental health websites.3
To increase the uptake and use of mobile health technologies, they should be functionally integrated within existing health applications or educational platforms.3 For treating mental health, digital interventions should be implemented with careful consideration of their ability to immediately identify and respond to a range of clinical scenarios, social issues, or other challenges that people with depression face.3
1. Decker V, Valenti M, Montoya V, Sikorskii A, Given CW, Given BA. Maximizing new technologies to treat depression. Issues Ment Health Nurs. 2019; 40(3):200-207.
2. McKay FH, Cheng C, Wright A, Shill J, Stephens H, Uccellini M. Evaluating mobile phone applications for health behavior change: A systematic review. J Telemed Telecare. 2018; 24(1):22-30.
3. Fleming T, Merry S, Stasiak K, et al. The importance of user segmentation for designing digital therapy for adolescent mental health: Findings from scoping processes [published online May 8, 2019]. JMIR Ment Health. doi: 10.2196/125656